POS1393 ULTRASOUND AS A POTENTIAL TOOL TO DETECT INTERSTITIAL LUNG DISEASE IN DAILY CLINICAL SETTING OF PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: M. Gutierrez, S. Ruta, D. Clavijo-Cornejo, G. Fuentes-Moreno, S. Reyes-Long, C. Bertolazzi
Journal: Annals of the Rheumatic Diseases (2022)

Background Interstitial lung disease (ILD) is the most common and relevant pulmonary complication, that contributes significantly to increased morbidity and mortality in rheumatoid arthritis (RA). Thus, increased awareness of this complication is a real challenge in the clinical setting; in particular, an accurate strategy to detect RA-ILD is crucial to assure the survival and quality of life of RA patients. In the last years, the pulmonary ultrasound (US) has been proposed to assess ILD in rheumatic diseases [1, 2]. Preliminary results have demonstrated a positive correlation between their findings and those of HRCT and diffusion capacity of carbon monoxide (DLCO). Although these results are exciting, the value and potential application of US in detect ILD in daily clinical setting of patients with RA remain to be clearly delineated. Objectives To investigate the potential role of US in the detection of ILD in a real-life cohort of patients with RA. Methods Patients with diagnosis of RA were consecutively enrolled. All patients underwent pulmonary examination, laboratory data, DLCO measure, chest HRCT and radiographs, and US examination. A healthy group was included as control group. US was performed according the 14-intercostal space scanning protocol using the following semiquantitative scale [0 = normal (≤5 B-lines); 1 = slight (≥6 and ≤15 B-lines); 2 = moderate, (≤16 and ≥30 B-lines); 3 = severe (≥30 B-lines)]. Results A total of 74 RA patients and 74 healthy controls were included. Thirty of 74 patients (40.5%) showed US signs of ILD with respect to the healthy controls (3 subjects, 4.1%) (p=0.0001); whereas HRCT showed ILD in 27 (36.4%) of 74 patients. Among the 30 patients that showed US findings of ILD, 17 (56.6%) were asymptomatic from respiratory view-point. The sensitivity and specificity of US were 92% and 89% respectively. A positive correlation between US and HRCT findings were found (p= &lt; 0.0001) whereas no correlation was found with chest radiographs and DLCO findings (p = 0.2971 and 0.7856 respectively). Positive association between US findings and DAS28-ESR, RF and anti-CCP (p=0.0076, 0.0044, 0.0074 respectively) was found. Feasibility, represented by the mean time spent to perform the pulmonary US assessment was 7.8 minutes (± SD 1.2, range 6 to 10 minutes). Conclusion Our results support the potential of US in detect accurately ILD in a real-life cohort of patients with RA and provide a rationale to consider it as a friendly screening tool to be implemented in early phases of the disease. References [1]Gutierrez M, Salaffi F, Carotti M, et al. Utility of a simplified ultrasound assessment to assess interstitial pulmonary fibrosis in connective tissue disorders-preliminary results. Arthritis Res Ther 2011Aug 18;13-R134. [2]Moazedi-Fuerst FC, Kielhauser S, Brickmann K, et al. Sonographic assessment of interstitial lung disease in patients with rheumatoid arthritis, systemic sclerosis and systemic lupus erythematosus. Clin Exp Rheumatol 2015;33:S87-91. Acknowledgements To the Pan-American League of Rheumatology Associations (PANLAR). Disclosure of Interests None declared